Several of our Therapists that are seeing clients in person have now been vaccinated. In addition to offering in person appointments we are also seeing clients for online sessions via video call.
Sunday, 25 Dec 2016

What is Borderline Personality Disorder (BPD)?

By Private Therapy Clinic

Dr Becky Spelman is a Psychologist who’s main area of speciality is borderline personality disorder (BPD).

In this video Dr Becky discusses borderline personality disorder (BPD) in detail covering the following areas:

  • Where does borderline personality disorder come from in the first place.
  • How to know if you might have borderline personality disorder.
  • What difficulties do people with borderline personality disorder experience.
  • What approaches are helpful for borderline personality disorder sufferers.
  • How to find a good therapist to help you overcome borderline personality disorder.

Dr Becky also welcomes any questions you might have about borderline personality disorder.

Video transcript:

What is Borderline Personality Disorder and where does it come from? Not a lot of people understand or realise that Borderline Personality Disorder always comes from early in life – from childhood experiences. This is a result of growing up in an environment where people’s emotions are not attended to. If someone has experienced childhood emotional neglect or even worse, childhood trauma, where they are left to deal with very difficult emotions on their own or their emotions are neglected or ignored, they may go onto develop Borderline Personality Disorder (BPD) or Borderline Personality Disorder Traits. However they may not meet the full criteria for the disorder.

A lot of people that I work with don’t actually meet the full criteria for the disorder. A lot of my clients are very high functioning, not suicidal, but in terms of the way they regulate their emotions, the difficulties they experience with their emotions, and the difficulties in their interpersonal relationships, then they would meet some of the criteria of Borderline Personality Disorder without meeting full diagnosis.  A lot of people think that it may actually be a nature problem rather than nurture, but nurture always has the key part to play.

Now, that’s not to say that somebody who grows up in an environment with emotionally neglectful parents, abusive parents, or traumatic circumstances will always go on to develop Borderline Personality Disorder because there is a natural innate personality element that has a part to play as well. However, there is a strong chance that somebody may go onto develop those symptoms or other emotional struggles, behavioural difficulty, or interpersonal difficulties if they grew up in an environment where their emotions were not understood, attended to, and nurtured.

This is where Borderline Personality Disorder always comes from. I don’t like the term Borderline Personality Disorder. I think that it gives quite a harsh label to people. I think it makes them sound really severe, really damaged, and there is a lot of misunderstandings about that label. The word Personality Disorder is a big label to put on someone, so ideally, I would like the difficulties to be called something else, however this is the label that is used.

When somebody has Borderline Personality Disorder, it can affect them in a number of different ways. They can experience a whole host of symptoms and experience a whole host of difficulties throughout their life without actually knowing what’s really wrong with them and where the problems come from in the first place. Someone who has Borderline Personality Disorder may experience social anxiety, self-esteem difficulties, eating disorders, drug addiction, love addiction, sex addiction, other behavioural problems, issues in relationships, domestic violence, body dysmorphic disorder. There are just so many difficulties that somebody with Borderline Personality Disorder can experience, and of course mood problems as well, difficulties regulating emotions.

In order to know whether you have Borderline Personality Disorder or not, you want to ask yourself, did you come from an environment where your emotions were attended to, understood, supported, and your parents really tried to connect with you emotionally. Perhaps, you might think of an instance where you did something wrong, do you remember the punishment or were your parents people who sat you down and said, “We love you very much, but this is why the behaviour was wrong…” and rather than labelling you as “bad,” they actually in a loving caring way explained why the behaviour you did was wrong.

The parent who lacks empathy is going to be quite erratic, quite unpredictable, they are going to punish children, and make them feel quite shamed, and like as if they’re doing something wrong, they can explode with anger, and children can end up walking on eggshells with these kinds of parents. Of course, in terms of a child intellect, a child will never thinks “Oh, there’s something wrong with my parents’ parenting skills…” They always think, “Oh no, there’s something wrong with me.” And this is why people with Borderline Personality Disorder who’ve grown up in this background of living in an environment where emotions are not attended to, where they’re ignored, or there’s a lot of trauma, this is why these people will develop self-esteem difficulties because they’ve been fed these messages for quite a long time and as a result think that there’s something wrong with them. As a child, they had no other way of understanding their parents’ erratic behaviour or understanding why their emotion is being ignored.

And this leads to a big problem for people who have Borderline Personality Disorder or Borderline Personality Disorder Traits. They end up receiving, from quite an early age the message that emotions are not important, and therefore, they shut these emotions off. They sweep them under the carpet, they learn not to feel very much, or to try not to feel very much which is an impossible task because we’re humans and we’ve been given every single emotion to help service in life, even the negative emotions. For example, when you think about anxiety, we’re standing on the edge of a cliff, we need to feel anxious to keep ourself safe. When we feel angry, maybe that’s because someone has mistreated us or we’re not happy with this situation, so we feel anger in order to help us take the steps that we need to resolve the problem. Every single negative emotion that we experience, I believe, serves us well, and we should feel all of our emotions, particularly people who allow themselves to feel very negative emotions, can access really positive emotions as well. They can access the full spectrum of emotions which makes us human.

By the time someone has reached 5 years old, they have learned to suppress their emotions if they’ve grown up in this environment where their emotions were not being attended to. And the child in this environment learns that, “Oh, these emotions I’m feeling are not very important and they’re not going to be attended to, so there mustn’t be very much use to them. It must be something wrong with me that I’m feeling this way. Okay, I’ll sweep these emotions under the carpet. I’ll try not to feel them. They’re obviously causing people problems and they’re bad. These negative emotions are not serving me well at all.” So, they pick up the strong messages, and then as a result, they start to go through life trying to suppress emotions and sweeping them under the carpet.

Different negative emotions might be bigger triggers for certain people. For example, if someone grew up in a household where they were punished for showing signs of anger, then that might be a particular emotion that they try the hardest to suppress. Whenever they start to feel anger, they might try very hard to distract themselves or not feel it, and this is where they will put in place all sorts of different behaviours to try and suppress their emotions. Of course, this can only work in the short term because trying not to feel negative emotions is like trying to keep the lid on an over carbonated bottle. It’s going to explode at some point and it’s going to cause people problems at some point if they’re trying to keep all these emotions within. You might have heard the explanation of someone turning anger inward and they end up experiencing a lot of depression because they’ve not worked through that anger or people being passive-aggressive because they’re trying to keep anger in, but it’s still seeping out and they’re showing signs of anger regardless.

This can cause people all sorts of difficulties. They can suppress so much emotions that all they are left feeling is a whole lot of anxiety because anxiety is almost impossible to suppress or there are a lot of conflict situations in their life, or there are a lot of situations where they don’t confront someone and negotiate their needs when they are clearly in a situation where they are not happy. And then, emotions can just burst out in ways when people least expect it if they’re not on a consistent basis working on regulating their emotions and feeling their way through their emotions or tackling situations head on when they’re experiencing negative emotions.

To help someone get better from Borderline Personality Disorder or Borderline Personality Disorder Traits, they need to do a lot of work on restructuring how they deal with their emotions. They will also need to work perhaps on their communication, and how they deal with their relationships and their interpersonal skills, how they deal with their different moods including anxiety, and also maybe some self-esteem problems as well. But it really does depend on the individual because not every person with Borderline Personality Disorder is the same. People with Borderline Personality Disorder come with all different types of personalities and the problems that they present with can come in all different shapes and forms as well.

How do you choose the right therapist for you if you want treatment for Borderline Personality Disorder? Well, a good therapist has to be someone who is incredibly knowledgeable about Borderline Personality Disorder. They need to know psychodynamic understandings and a psychodynamic framework very well so that they can understand where your difficulties came from in the first place, and then they need to be quite skilled at helping you with all of the emotional stuff and all of the behavioural difficulties that you might have as well because you will probably participate in some unhelpful behaviours as a result of the emotions that you experience. Somebody who has DBT (dialectical behaviour therapy) skills can be very helpful and someone who has mindfulness and CBT (cognitive behavioural therapy) skills as well can be very helpful. It is unlikely that a therapist who just knows one approach is going to be able help you and they need to be a senior practitioner who has been working with Borderline Personality Disorder for a very long time, so that they can really understand you. However, one of the most powerful things that is going to help you achieve change and help you get better and help you achieve your goals is going to be that therapeutic relationship. Are you warming to this practitioner? Can you trust them? Are they patient and understanding? And are they able to truly put themselves in your shoes?

One of the things about Borderline Personality Disorder is that some of the difficulties that people will be bringing if they have this disorder will come across quite immature because people with Borderline Personality Disorder are emotionally immature compared to their age and that’s okay. However, a therapist who doesn’t understand Borderline Personality Disorder is going to get frustrated with that or maybe not really understand why is this person not presenting as a mature adult. How come they can be so high functioning in this area of their life, so smart, intelligent, and able to make good decisions in relation in these areas of their life but why are they acting so emotionally immature in relation to these areas.

When a therapist truly understands Borderline Personality Disorder, you’re not going to get judgment in terms of whatever you’re bringing no matter how petty the issue might be or how immature some of your functioning might be. That’s okay. As humans, we’re not perfect. This is just an area that you’ve decided to address, and if you can find the right person, the right therapist, who truly understands the disorder, you can get treatment without judgement.

The questions that you should be asking your therapist that you’re considering to help you with Borderline Personality Disorder is how long have they worked with borderline clients for? What’s their understanding of Borderline Personality Disorder? How many years post training are they? And what different approaches do they use? Also, you want to be paying close attention to how your therapist is making you feel. Pay close attention intuitively and use your intuition to guide you to choosing the right therapist. This might take some time to realise whether that relationship is going to be a good match for you or not but don’t leave that therapeutic relationship without addressing some of the things you’re not satisfied with. Give your therapist an opportunity to stick up for them self and see how they deal with your emotions.

If you’ve got any questions about anything in today’s video, feel free to comment and I’ll be happy to make some more videos addressing your questions.

I’m Dr. Becky Spelman and thanks for watching.

Who can I speak to further about the issues in this article?

For help with the issues discussed in this article speak to one of our therapists here at Private Therapy Clinic.

Check out other related articles